<!doctype html>
<html>
<head>
    <title>商家注册</title>
    <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
    <meta content="width=device-width,initial-scale=1,maximum-scale=1, user-scalable=no" name="viewport"/>
    <meta name="apple-mobile-web-app-capable" content="yes" />
    <meta name="apple-mobile-web-app-status-bar-style" content="black" />
 	<link href="css/crm-min.va8b8cfff.css" rel="stylesheet"/>
    <link rel="shortcut icon" href="http://www.meituan.com/favicon.ico" type="image/x-icon" />
    <link rel="Bookmark" href="http://www.meituan.com/favicon.ico" type="image/x-icon" />
    <meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />



 
    
</head>
<body class="theme-cos">


<div id="add-business-opportunity">

    <div class="infos clearfix">
        <div class="boform-info">
        <div class="mainbox">
            <div class="content">
            <div class="title-tip">个人信息</div>
            <div class="navbar-container category clearfix">
                
            </div>
            <form id="feedback-form" class="common-form" method="post" action="/register">
                <input type="hidden" id="J-pic-key" name="licenseFileKey"/>
                <div class="field-group">
                    <label class="field-item" for="sellerName">您的姓名</label>
                    <input  name="sellerName" autofocus autocomplete="off"  tabindex="1" id="fullname"  class="f-text smiddle-text user-name"  value=""/>
                </div>
                <div class="field-group">
                    <label class="field-item" for="number">联系方式</label>
                    <input name="mobile"  autocomplete="off" tabindex="2" id="number" class="f-text smiddle-text mobile"  value=""/>
                </div>
                <div class="field-group">
                    <label class="field-item" for="email">邮箱</label>
                    <input name="email"  autocomplete="off" tabindex="3"  id="email" class="f-text smiddle-text email" value=""/>
                </div>
                <div class="field-group">
                    <label class="field-item" for="contacts">其他联系方式</label>
                    <input name="qq" id="contacts" class="f-text smiddle-text" autocomplete="off" tabindex="4"  value=""/>
                </div>

 
                <div class="field-group">
                    <label class="field-item" for="category">商家类型</label>
                    <div class="relative">
                      <input type="text"  class="f-text smiddle-text cat-name"  id="category"  name="type" autocomplete="off" tabindex="12" />
                    </div>
                </div>
 <hr/>
                <div class="field-group">
                    <label class="field-item" for="feedback-bizname">门店名称</label>
                    <input type="text" maxlength="100" name="shopName"  id="feedback-bizname" tabindex="5" autocomplete="off" class="f-text smiddle-text branch-name" value=""/>
                </div>
                <div class="field-group">
                    <label class="field-item" for="feedback-city">城市</label>
                    <span>
                        <input type="text" class="f-text short-text city-name" autocomplete="off" name="city" tabindex="6" id="feedback-city"/>
                    </span>
               </div>
               <div class="field-group">
                    <label class="field-item">区域</label>
                     <input type="text" class="f-text short-text district-name"  autocomplete="off" tabindex="6" name="town"/>
                      
                   
             </div>
               <div class="field-group"> 
                    <label class="field-item" for="feedback-detailAddress">详细地址</label>
                    <textarea name="details" maxlength="250" tabindex="9" class="address" id="feedback-detailAddress" ></textarea>
                   </div>
               <div class="field-group">
                    <label class="field-item" for="tele">门店电话</label>
                    <input type="text" name="tele" id="branch-phone" class="f-text smiddle-text" autocomplete="off" tabindex="10" value=""/>
 				</div>
            </form>
            
        </div>

    </div>
</div>
   
         

 
</body>
</html>

